Donovan, Brian P

Donovan, Brian P is an individual health care provider with primary practice located at 119 Boone Ridge Dr Suite 201, Johnson City TN 37615-4998. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Donovan, Brian P can be contacted via phone (423) 282-1480.

Contact Information

Primary practice address
119 Boone Ridge Dr Suite 201 Johnson City TN 37615-4998
Phone: (423) 282-1480
Fax: (423) 928-1353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 19590 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19590 Tennessee

Profile Details

NPI number 1598741787
LBN Legal business name Donovan, Brian P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Oct 10th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598741787 NPPES
Tennessee Other 201217521 PHP
Tennessee Other 4121972 PHP
Tennessee MEDICAID 010344638 PHP
Tennessee Other TN0111 PHP
Tennessee MEDICAID 3046236 PHP

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